Low doses of cholestyramine in the treatment of hyperthyroidism.
The enterohepatic circulation of thyroid hormones is increased in thyrotoxicosis. Bile-salt sequestrants bind thyroid hormones in the intestine and thereby increase their fecal excretion. Based on these observations, the use of cholestyramine has been tried. The present study evaluates the effect of low doses of cholestyramine as an adjunctive therapy in the management of hyperthyroidism. In a prospective, randomized, double-blind, placebo-controlled trial, 45 patients with newly diagnosed hyperthyroid Graves' disease were randomly assigned into the following treatment protocols: group I, cholestyramine 2 g BID, methimazole and propranolol; group II, cholestyramine 1 g BID, methimazole and propranolol; group III, placebo powder, methimazole and propranolol. The fixed dose of methimazole (30 mg/d) and propranolol (40 mg/d) was used. The study period was 4 weeks. Serum total triiodothyronine and free thyroxin were measured at baseline, and at the ends of the second and the fourth week of the study. The serum thyroid hormone levels decreased more rapidly and to a greater extent in the cholestyramine-treated groups. All of the patients in group I had achieved euthyroid state at the end of the study. We conclude that low dose of cholestyramine is an effective and well-tolerated adjunctive agent in the treatment of hyperthyroid Graves' disease.
Kaykhaei
Mahmoud Ali
MA
Endocrine and Metabolism Research Center, Namazi Hospital, Shiraz University of Medical Sciences, P.O. Box 71345-1414, Shiraz, Iran.
Shams
Mesbah
M
Sadegholvad
Abdosamad
A
Dabbaghmanesh
Mohammad Hossein
MH
Omrani
Gholamhossein Ranjbar
GR
D000328:Adult; D013956:Antithyroid Agents / Q000008:administration & dosage; D002792:Cholestyramine Resin / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006111:Graves Disease / Q000150:complications / Q000188:drug therapy; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008713:Methimazole / Q000008:administration & dosage; D008875:Middle Aged; D010919:Placebos; D011433:Propranolol / Q000008:administration & dosage; D055815:Young Adult
D013956:Antithyroid Agents; D010919:Placebos; D002792:Cholestyramine Resin; D008713:Methimazole; D011433:Propranolol